Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Studies demonstrate that revision rates after primary total knee arthroplasty (TKA) tend to be higher in obese patients. However, the existence of a body mass index (BMI) threshold remains unexplored.We conducted a prospective cohort study of 2442 primary TKAs in 2035 patients (69.1 % women; mean age 72 years; mean follow-up 93 months, range 38-203). We evaluated the influence of BMI in five categories on all-cause revision after TKA using incidence rates (IR), hazard ratios (HR), and Kaplan-Meier survival analysis. Adjustment for baseline imbalances was performed using Cox regression analysis.Over the study period, 71 revisions occurred. Revision rates were 3.2 cases/1000 patient-years for patients of normal weight, 3.4/1000 for overweight patients and 3.0/1000 for patients classified as obese class I. At BMI ≥ 35, a significant increase in revision was noted. Comparing BMI ≥ 35 vs. < 35, there were 6.4 vs. 3.2 /1000. Crude HR was 2.0 [95 % confidence interval (CI) 1.2-3.3, p = 0.009], and the adjusted HR was 2.1 (95 % CI 1.2-3.6, p = 0.008).All-cause revision rates after primary TKA doubled in patients with a BMI of 35 but were similar in those with a BMI <35.

Original publication

DOI

10.1007/s00264-015-3031-0

Type

Journal article

Journal

International orthopaedics

Publication Date

04/2016

Volume

40

Pages

723 - 729

Addresses

Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1211, Genève 14, Switzerland. matthieu.zingg@hcuge.ch.

Keywords

Humans, Obesity, Body Mass Index, Arthroplasty, Replacement, Knee, Reoperation, Proportional Hazards Models, Regression Analysis, Cohort Studies, Follow-Up Studies, Prospective Studies, Aged, Middle Aged, Female, Male, Overweight, Kaplan-Meier Estimate